MEDICARE: MS. CATHERINE ANN VALENTINE LCPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	180006177	IL

General Provider Information

NPI Number	:	1205062593
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CATHERINE ANN VALENTINE LCPC

Provider Business Mailing Address
First Line	:	37131 N GANSTER RD
Second Line	:
City	:	BEACH PARK
State	:	IL
Zip	:	60087-3162
Country	:	US
Telephone Number	:	847-244-6992
Fax Number	:	847-244-6992

Provider Business Practice Location Address
First Line	:	37131 N GANSTER RD
Second Line	:
City	:	BEACH PARK
State	:	IL
Zip	:	60087-3162
Country	:	US
Telephone Number	:	847-244-6992
Fax Number	:	847-244-6992

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2009
Last Update Date	:	08/29/2022

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